Ask the Expert
Breast Cancer Reconstruction By Jorge A. Perez, M.D., F.A.C.S.
O
ctober is breast cancer awareness month.
Great strides have been made in both cancer diagnosis and treatment of this disease which is one of the most common disorders affecting women. Today, many options exist for reconstruction following breast lumpectomy or mastectomy allowing women to enjoy a greater quality of life. There are several important and timely decisions to consider in achieving an optimal outcome with breast cancer reconstruction. These choices can be overwhelming, so here are five steps to help women work through this difficult time.
Step 1: The Cancer Operation
10/31/2012
Following the diagnosis of breast carcinoma, a woman’s first consultation should be with a general surgeon experienced in all of the options for removal of the cancer. Together they should decide upon mastectomy or less radical surgery such as lumpectomy, as well as the role of adjuvant treatment such as chemotherapy and radiation. Based upon these plans a referral to a plastic surgeon with expertise in breast surgery is in order.
Step 2: Immediate vs. Delayed Reconstruction
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The initial consultation with a plastic surgeon includes a thorough medical history and directed physical examination. The first decision will be whether to delay the breast reconstruction or begin at the time of mastectomy. The latter is regarded as an “immediate” reconstruction. Coordinated surgery offers the advantage of a single operation and fresh tissue planes for a cleaner and faster reconstruction, although delayed breast reconstruction can also be safely performed years after a mastectomy.
Step 3: Autologous Tissue vs. Prosthesis Reconstruction
The detailed plastic surgery discussion should include the types of reconstruction. There are several procedures available for creation of a new breast mound ranging from simple implant placement to microsurgery. The choice will depend upon several variables including the patient’s desires and body type. Autologous reconstruction is performed using the woman’s own body fat from the belly, back or buttocks. These can be lengthy and more complicated procedures. Breast implants, with or without expansion of the chest skin, is called prosthesis reconstruction.
Step 4: The Other Breast
A healthy breast can be reshaped as well. Breast augmentation, lift or reduction for the purpose of achieving symmetry to the reconstructed breast may be necessary and should be included in the reconstructive planning.
Step 5: Nipple and Areolar Reconstruction
Once a new breast mound has been formed the final phase is the optional creation of a nipple and/or areola. Many procedures exist for this purpose. Although these are not mandatory, the results can be amazing. Finally, and fortunately, laws exist to protect women during this vulnerable time. Florida law mandates coverage for both the reconstructed breast as well as the other healthy breast, if necessary, to achieve symmetry. Dr. Jorge Perez is a member of the NOVO National Council of Leaders in Breast Aesthetics. He has served as a consultant for both Mentor (J&J) and Inamed (Allergan), leading breast implant manufacturers. Dr. Perez has lectured internationally on the subject of breast surgery and has been selected among the Castle Connolly (U.S. News & World Report) America’s Top Doctors. His office aggressively advocates only on behalf of patients, not insurance plans. More information is available at www.PerezPlasticSurgery.com or by calling (954) 351-2200.
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